Donald Trump may be ready to move on after abandoning his effort to repeal and replace Obamacare, but the fallout from the collapse of the G.O.P. bill still threatens to create fresh hells for the White House. The American Health Care Act would have effectively defunded Planned Parenthood, by preventing states from giving federal funds to any health-care provider that “primarily engaged in family planning services, reproductive health, and related medical care” or “provides for abortions.” But just because Obamacare will remain the law of the land for “the foreseeable future,” as House Speaker Paul Ryan lamented on Friday, doesn’t mean that conservatives are ready to give up on defunding the popular women’s health organization. And they may be willing to shut down the government to do so.

April 28 marks the end of a continuing resolution to keep the government funded, and unless Congress passes a new budget, the government will hit the debt ceiling and begin shutting down on the 29th—the 100th day of Trump’s presidency. Unfortunately for people who prefer to have a working government, Republicans and Democrats appear to be at an impasse. As Trump himself tweeted angrily at the House Freedom Caucus, the conservative faction primarily responsible for derailing the A.H.C.A., failure to pass the bill also means that Capitol Hill now faces a potentially even more contentious battle over Planned Parenthood. The pro-life coalition is likely to demand that the new budget strip federal funding from the women’s-health service. But even if such a bill passes through the House, there is no way that such a bill gets 60 votes in the Senate, where Democrats still hold 48 seats. If conservatives hold the line, and Democrats filibuster, the government could be on track to run out of money by this time next month.

As the health care debacle revealed, the Republican-controlled Congress is far more divided and dysfunctional than it appeared on Inauguration Day, when conservatives on Capitol Hill were abuzz with the possibility of unitary government control. Ryan, the House Speaker, is left with only bad options: defunding Planned Parenthood and setting the country on the path to another shutdown, or leaving out the Planned Parenthood provision, trading Republican backing for Democratic support. This is precisely the dilemma that former speaker John Boehner repeatedly encountered, before giving up and settling into what appears to be a happy retirement.

For now, Democrats appear ready to fight if Republicans try to sneak in any amendments anathema to their agenda. “If they put those poison-pill amendments in and try to shove them down the American people's throats, of course they might be responsible for shutting the government down,” Senate Minority Leader Chuck Schumersaid in a press conference earlier this month. With Wall Street already on edge after the failure of the G.O.P. health-care bill—and what its failure presages for tax reform—the financial fallout from a potential shutdown could be dire. “We may be facing the same crap on a shutdown threat, and on the debt ceiling. Holy crap!” one banking executive exclaimed to Axios’s Mike Allen. “We may not get tax reform, or a repatriation bill, or infrastructure spend, or substantial changes to regulations.”

If that’s a risk Ryan isn’t willing to take, the current Trumpian coalition may need to readjust, as both House leadership and the White House are forced to seek Democratic support to replace pro-life Republicans who race for the exits. The result could be a significant political realignment, if the president plays his cards right. Already, there are rumors that Trump may seek to reach out to the Congressional Black Caucus on future legislation, striking a grand bargain on taxes and infrastructure. Of course, that would require that Trump have learned from his most recent failures.